Krupski Witold, Majcher Piotr
II Zakład Radiologii Lekarskiej, Akademia Medyczna im. Prof. Feliksa Skubiszewskiego, Lublin.
Ortop Traumatol Rehabil. 2004 Nov-Dec;6(6):809-18.
Summary. Spondylolysis involves disruption of the bone structure at the vertebral arch at the isthmus. Various methods are utilized in diagnosing spondylolysis, such as plain radiography, computed tomography (CT), magnetic resonance (MR), and scintigraphy. Plain radiography with anteroposterior (A-P) and lateral views is a useful method in the initial diagnostics of low back pain. Although lateral views have great value in the assessment of the progression of slippage, dynamic views are useful for the determination of vertebral stability, while oblique views seem be less precise. There is evidence that CT has the greatest value in the diagnosis of spondylolysis and lumbar spine evaluation generally. The use of multiplanar reconstruction (MPR) and three-dimensional (3D) reconstruction have increased the reliability and value of CT examination, when only axial sections are analyzed. CT examination with MPR and 3D reconstruction enables reliable, diagnosis of spondylolysis and attendant complications, such as nucleus pulposus herniation, spondylolisthesis, and narrowing of intervertebral foramina and the vertebral canal. MR imaging is useful is assessing soft tissues, and should be utilized primarily in neurological complications. Scintigraphy does not seems to have any practical importance in evaluating spondylolysis.
总结。峡部裂是指椎弓峡部的骨质结构中断。诊断峡部裂有多种方法，如X线平片、计算机断层扫描（CT）、磁共振成像（MR）和骨闪烁显像。正位和侧位X线平片是诊断腰痛的常用初始方法。虽然侧位片在评估滑脱进展方面有很大价值，但动态位片对确定椎体稳定性有用，而斜位片似乎不太准确。有证据表明，CT在峡部裂诊断及腰椎评估中总体价值最大。当仅分析轴位图像时，多平面重建（MPR）和三维（3D）重建的应用提高了CT检查的可靠性和价值。采用MPR和3D重建的CT检查能够可靠地诊断峡部裂及相关并发症，如髓核突出、椎体滑脱、椎间孔和椎管狭窄。磁共振成像在评估软组织方面有用，主要应用于神经并发症。骨闪烁显像在评估峡部裂方面似乎没有任何实际意义。
